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Enough doctors? Only if we free the market in medical training. Your editorial is correct: there cannot be too many women doctors and the medical profession is "focusing on the wrong issue". We need more doctors, full stop. Stealing them from other countries is no solution, we need to train more ourselves.

Central planning of medical education, however, is too rigid. One way to increase the number of doctors is to increase the number and variety of medical courses on offer.

The General Medical Council inspects and approves medical schools and their examinations but has no effective way of assuring equivalence in the standard of their graduates.

A 1993 study published in the British Medical Journal showed that the fail rate in the national postgraduate medical examination (MRCGP) varied from under 6 per cent (Oxford) and under 10 per cent (Bristol, Cambridge, Nottingham, Royal Free, Southampton) to more than 20 per cent (Aberdeen, Dundee, Liverpool, Welsh National School of Medicine) and over 30 per cent (Glasgow).

The GMC needs to develop a national UK medical qualifying examination, taken by all medical students. This would permit the government to relax central planning and invite any university to establish a medical course, whose product would be assessed not by GMC inspection and its educational prejudices, but by the standardised examination.

Richard Wakeford Convenor of the Cambridge Conferences on Medical Education Hughes Hall, University of Cambridge

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